Objective To analyze the quality of life and its influencing factors in the elderly tumor patients transitioning out of the intensive care unit (ICU). Methods A retrospective analysis was conducted of the clinical data of 240 elderly tumor patients in ICU of Affiliated Tumor Hospital of Xinjiang Medical University between June 2021 and February 2023. All patients were in the transition period of ICU transfer. The patients with a score<50 on 36-item short-form health survey (SF-36) were included in the observation group (n=70), and those with a SF-36 score≥50 in the control group (n=170). The physical status (ZPS) score was used to evaluate the patient′s general condition and health status, the mini-nutritional assessment scale (MNA) to evaluate the patients′ nutritional status, the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) to evaluate the patients′ psychological status, and visual analogue scale (VAS) to evaluate pain level. SPSS 20.0 was used for statistical analysis. Data comparison between two groups was performed using t-test or χ² test, depending on the data type. Multivariate logistic regression analysis was used to analyze the influencing factors on the quality of life of the elderly tumor patients transitioning out of ICU. Results The SF-36 scores and medical service satisfaction in the observation group were significantly lower than those in the control group [(41.15±5.74) vs (68.88±7.43) points; (83.43±8.87) vs 9(4.65±9.46) points] with statistically significant differences (P<0.05 for both). The proportions of patients aged 76-85 years, chronic diseases>3 types, severe depression, severe anxiety, moderate pain, surgical treatment and ICU stay>5 d, and ZPS scores in the observation group were significantly higher than those in the control group, but the levels of white blood cell and platelet count and MNA scores were significantly lower than those in control group (P<0.05 for all). Multivariate Logistic regression analysis indicated that moderate pain (OR=2.964,95%CI 2.004-7.964) and ICU stay>5 d (OR=5.750,95%CI 2.442-7.975) were the risk factors of the decline in the quality of life in the elderly tumor patients transitioning out of ICU, while MNA score (OR=0.973,95%CI 0.955-0.991) was the protective factor (P<0.05). Conclusion The quality of life declines in the elderly tumor patients transitioning out of ICU. Medical staff should closely monitor the patients for changes in condition and their psychological state and implement the treatment measures based on their quality of life to promote their physical recovery.